Toxoplasmosis is an infection in humans caused by protozoan parasites (single-celled organisms). Toxoplasma gondii (T. gondii). This parasite is often found in cat litter or undercooked meat. Parasitic infection T. gondii in healthy people it is generally harmless, because the immune system can control this parasitic infection. However, serious medical treatment needs to be done if this infection attacks someone with a low immune system or pregnant women, in order to avoid serious complications.
Toxoplasmosis is spread from animals to humans (zoonosis), not between humans, except in pregnant women who can spread the infection to their fetuses. As a result, the fetus experiences slow development. Even in cases of more severe infection, miscarriage or fetal death can occur in the womb.
After toxoplasmosis occurs, the parasite T. gondii can survive in the body in an inactive state, thus providing lifelong immunity against infection with this parasite. However, when the body's immune system is weakened due to an illness or consumption of certain drugs, infection can occur T. gondii can reactivate and lead to more severe complications.
Toxoplasmosis is also thought to reduce female fertility. However, this still needs to be investigated further.
Symptoms of Toxoplasmosis
Moment T. gondii In a healthy person, symptoms may not appear and the sufferer may recover completely. But in other cases, symptoms can appear for several weeks or the symptoms are usually mild and similar to flu symptoms, namely fever, muscle aches, fatigue, sore throat, and swollen lymph nodes. These symptoms may improve within 6 weeks.
Infection T. gondii in infants and children is generally transmitted from the mother during pregnancy. More serious symptoms can be experienced by fetuses infected with this parasite in the early trimester of pregnancy, in the form of premature birth, miscarriage, or fetal death in the womb. Meanwhile, babies born with infected conditions T. gondii (congenital toxoplasmosis) will show symptoms, such as:
- Yellowish skin.
- Inflammation of the chorion (chrionitis) or infection of the back of the eyeball and retina.
- Enlargement of the liver and spleen.
- Skin rash or skin that bruises easily.
- seizures.
- Accumulation of cerebrospinal fluid in the head, so that the head becomes large (hydrocephalus).
- The head appears smaller (microcephaly).
- Intellectual impairment or mental retardation.
- Hearing loss.
- Anemia.
These symptoms can appear when the baby is born, or only be seen months or years later.
Meanwhile, in immunocompromised patients,, Symptoms of toxoplasmosis infection are characterized by:
- Difficulty speaking, visual impairment, hearing loss, dizziness, looking confused, convulsions, to coma, if toxoplasmosis attacks the brain.
- Rash, fever, chills, weakness, and shortness of breath, if toxoplasmosis spreads throughout the body.
Causes of Toxoplasmosis
Toxoplasma gondii is a single cell parasitic organism (protozoa) that can spread infection in animals (both wild animals and dirty pets) and humans. Although this parasite can grow in the tissues of many animals, it is more common in cats. This parasite lays eggs in the lining of the cat's intestines, and can be excreted with the animal's feces.
Spread of infection T. gondii in humans occurs by:
- Exposure to cat litter that contains parasites T. gondii.
- Consuming food or drink contaminated with parasites T. gondii, including raw meat that contains this parasite.
- Through the placenta of pregnant women, which spreads the infection to the fetus.
- Through blood transfusions or organ transplants from donors infected with this parasite.
There are several conditions that can increase the risk of toxoplasmosis becoming a serious health disorder, namely:
- Pregnant.
- Taking long-term corticosteroid or immunosuppressive drugs.
- Suffering from HIV/AIDS.
- Is undergoing chemotherapy.
Diagnosis of Toxoplasmosis
Doctors can suspect a patient has toxoplasmosis based on the existing symptoms. To prove it, it is necessary to do a blood test to determine the body's antibody levels against the parasite T gondii, for example with rapid test antibody. From rapid test, can be obtained negative and positive results. A negative result means the body has not been infected or is immune to the parasite T. gondii. However, this test can be carried out when the body has not yet formed antibodies against this parasite, so the results will be negative. To be sure, this test needs to be repeated a few weeks later. While a positive result indicates an infection in the body is active or this infection has occurred before.
In patients who are positive for toxoplasmosis and are at high risk of complications, the doctor will perform an MRI scan to determine whether the infection has spread to the brain.
Meanwhile, in pregnant women, to find out whether toxoplasmosis affects the fetus, doctors need to perform tests in the form of:
- Amniocentesis. The doctor will take a sample of the patient's amniotic fluid when the gestational age is above 15 weeks. With this test, it can be known whether the fetus is also infected with toxoplasmosis or not.
- ultrasound. This examination aims to look for abnormal signs in the fetus, such as hideocephalus. After delivery, the baby will undergo a series of examinations to see if there is any damage caused by infection.
Toxoplasmosis Treatment
Most cases of toxoplasmosis are only classified as mild, and do not require medical treatment. Patients can fully recover within 6 weeks.
Medical treatment in the form of medication is needed to treat patients with acute toxoplasmosis. Drugs that can be prescribed by a doctor for this case include: pyrimethamine and sulfadiazine.Meanwhile, in patients with toxoplasmosis with eye infections, corticosteroid drugs can be added to relieve inflammation.
Meanwhile, for pregnant women infected with toxoplasmosis, treatment is determined based on the time of infection and its effect on the fetus. If the fetus has not been infected or the infection occurs before the 16th week of pregnancy, the doctor will give antibiotics spiramycin. This drug is commonly used in the early trimester of pregnancy to reduce the risk of neurological disorders in the fetus. If the fetus has contracted toxoplasmosis after the 16th week of pregnancy, the doctor will prescribe pyrimethamine and sulfadiazine.
In infants born with toxoplasma infection, these drugs need to be given for 1 year after birth, and the baby's health condition must continue to be monitored while taking these drugs.
To treat toxoplasmosis in patients with low immune systems (immunity), doctors can give drugs, such as: pyrimethamine with clindamycin. Taking this drug may take 6 weeks or longer. When toxoplasmosis recurs in a patient with a weak immune system, the drug can be continued until the body's immunity improves.
Complications of Toxoplasmosis
Complications that can be caused by toxoplasmosis include:
- Blindness. This condition occurs in people with toxoplasmosis who have an eye infection, which is not treated properly.
- Encephalitis. Serious brain infections can occur in people with toxoplasmosis with low immune systems due to HIV/AIDS.
- Hearing loss, visual impairment, and mental retardation. This complication can afflict newborns with toxoplasmosis
Toxoplasmosis Prevention
There are several things that can be done to reduce the risk of getting toxoplasmosis infection, namely:
- Use gloves when gardening or handling soil.
- Avoid eating raw or undercooked meat.
- Wash hands before and after handling food.
- Wash all kitchen utensils thoroughly after cooking raw meat.
- Always wash fruits and vegetables before consumption.
- Avoid drinking non-pasteurized goat's milk or its processed products.
- For those who keep cats, should maintain the health of these animals, and use gloves when cleaning the litter box. Avoid keeping stray cats, because they are susceptible to parasitic infections T. gondii.
- Give your cat dry or canned food instead of raw meat.
- Cover the litter box where the children play so that the cat doesn't use it for littering.